PATIENTS could be charged for missing a GP appointment or calling 999 for an ambulance they do not need.

The Western Mail understands that Health Minister Edwina Hart is looking into introducing a “cost system” for patients who waste GP appointments and the Welsh Ambulance Service’s time.

She is also considering the possibility of publishing a leaflet which explains the costs of missing GP appointments and using the ambulance service unnecessarily.

The move comes amid growing concern about the number of GP appointments wasted every year by patients who fail to turn up.

And paramedics have spoken of their frustration of answering emergency 999 calls from patients who have nothing wrong with them.

Some dental practices in Wales are already warning patients that missing two appointments without giving more than 24 hours’ notice of cancellation could result in them being removed from the practice’s list.

It is estimated that 500,000 GP appointments and a further 260,000 practice nurse appointments are wasted every year in Wales by patients who fail to turn up. And across the UK, it has been estimated the problem costs the NHS up to £200m a year.

In some group practice surgeries a week’s worth of one of the GP’s appointments can be wasted every single week. (CORR)

If these appointments had been cancelled they could have been released for other patients who needed to see a GP or practice nurse, improving patient access.

Surveys by the health education charity Developing Patient Partnerships have suggested there is some support among GPs for charging patients a nominal fee of £10 for missing an appointment, or even striking persistent non- attenders off the register.

Dr Andrew Dearden, a Cardiff GP, said: “I have a list of 7,400 patients and I suspect that I have at least five or six who do not turn up every day, day in day out.

“But I couldn’t do the same as a dentist and refuse to see a patient before they pay up and I wouldn’t want to be put in that position.”

Dr David Bailey, chair of the Welsh GP committee, said: “It would make great difficulties for GPs if we were to start charging patients for missing appointments. I’m not sure the same concerns would apply to misuse of the ambulance service because it is easier to define misuse and the service does not have the same ongoing relationship with patients.

“We do need an education programme about the impact of missed appointments in primary care but we are not happy with the idea of charging because it raises enormous issues about inequalities and it would interfere with the doctor-patient relationship.”

Paramedics in Cardiff have told the Western Mail that they regularly have to deal with unnecessary 999 calls.

Examples include a patient who dialled 999 after suffering a paper cut; a man who called for an ambulance to ask paramedics to rub cream on his back; a woman who had been told by her GP that she had a bug and demanded to be taken to hospital; and a man who dialled 999 after stepping on a “foreign” bee in the early hours of the morning, but had no symptoms of an allergic reaction.

Every time the ambulance service responds to one of these calls, it means that an ambulance is not available to respond to a life- threatening emergency, meaning genuine patients often have to wait longer. Each ambulance call costs about £376, which includes the cost of control, overheads, vehicles and crews.

A spokesman for the Welsh Ambulance Services NHS Trust said that in 2007-08, 0.7% of calls – about 168 a month – were classified as a hoax.

He added: “Although we do not receive many calls which are regarded as hoax calls or misuse of service calls, clearly any of these calls keep an emergency ambulance away from a genuine potentially life-threatening situation.

“We are a busy service, and such calls only put those who genuinely need our service at greater risk.

“We would welcome any initiatives to educate the public regarding our service and ensure that the calls made to us are appropriate and necessary.”

Patients’ Association spokeswoman Vanessa Bourne said: “It’s interesting that the Assembly Health Minister is thinking of doing this, because it’s one of those things that has been talked about for years by the British Medical Association.

“It has been a problem for years with people wasting money like this and we’re all for making the system as efficient as possible.

“But the thing that works best – if patients don’t take appointments seriously – is if next time they want one the doctor says: ‘Well, we’re sorry, if you don’t take your appointments seriously, neither will we. We’ll not treat you as a priority.’

“There is nothing that works more efficiently than that.

“As long as it’s possible for a patient to get in touch to say an appointment cannot be kept, I think all these different systems are fair enough, because people are taking up appointments that others could have had.